Tonsillectomy Passes the Taste Test

Action Points

Explain to patients that tonsillectomies do not appear to have significant persistent effects on taste perception or sensitivity.

Note, however, that this study was a small one.

VIENNA, Austria, July 17 -- Tonsillectomies only rarely affect taste perception, according to investigators who tested patients' sense of taste both before and after the surgery.

Although many of the 65 adults reported a subjective decrease in taste function after the surgery, none lost it all together, reported Christian A. Mueller, M.D., of the Medical University of Vienna, and colleagues, in the July issue of the Archives of Otolaryngology--Head & Neck Surgery.

Nor did the investigators find any significant differences between pre- and post-surgery taste test scores.

Although there are published case reports of taste disorders following tonsillectomy, the authors found little evidence to support the notion that removing tonsils might rob the patient of the sensual pleasure of taste.

The investigators evaluated the effect of tonsil removal on gustatory sensation in 42 women and 23 men ages 15 to 68. All patients had gustatory testing on the day before surgery.

Testing was done using filter-paper taste strips, each impregnated with various concentrations of sweet, sour, salty, and bitter solutions. The strips were placed in random order at the posterior area of the tongue approximately 1 cm from the circumvallate papillae, and at the anterior area approximately 1.5 cm from the tip on both sides.

In all, 32 patients were available for post-tonsillectomy testing, which was performed from 64 to 173 days after surgery. The remaining 33 patients were interviewed by telephone about their subjective impressions of post-tonsillectomy taste.

The investigators found that, although there were significant differences between taste scores obtained in the posterior compared with the anterior area of the tongue (P=0.001), tonsillectomy had no major effect on taste scores obtained before surgery or after (P>0.27). Those findings remained essentially unchanged after controlling for age and gender (P<0.18).

When the patients were asked to subjectively rate their taste sensitivity, there was a significant decrease as measured on a visual analog scale, from 62.3 + 18.3 before tonsillectomy, to 51.1 + 14.5 after (P=0.001).

But in their self-rating of taste function, there were no reports of persisting gustatory dysfunction after surgery, although 15 of the 65 patients said they had some things just didn't taste right shortly after the procedure.

To put their study into context, the investigators noted that a retrospective analysis of 3,583 outpatients of a specialized taste disorder clinic over a 15-year period, showed "only 11 patients could be identified as having taste disorders after tonsillectomy."

"In three patients, gustatory loss was attributed to disturbance of the lingual branch of the glossopharyngeal nerve, whereas the other causes included adverse effects of drugs, zinc deficits, or remained unknown," they said. "Compared with the present prospective data, these data indicate the rare occurrence of taste disorders after tonsillectomy."

The study was supported by a grant to Dr. Mueller from the Medizinisch-Wissenschaftlicher Fonds des Burgermeisters der Bundeshauptstadt Wien. The authors had no financial disclosures.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco

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